Exploring the use of submental flap for parotid region reconstruction: a multicentric experience.

Abstract

Objectives: This study aims to evaluate the effectiveness and reproducibility of the submental island flap (SIF) for reconstructing defects in the parotid region after oncological surgery. The primary goals are to assess the flap's impact on patient morbidity, its overall feasibility in complex head and neck reconstructions, and its potential for consistent outcomes across different cases.

Methods: A retrospective multicentric study was conducted across 6 tertiary centres in Northern Italy, reviewing cases from 2015 to 2023. Inclusion criteria encompassed adult patients undergoing parotid region reconstruction using the SIF, specifically for defects arising from parotid or associated skin tumours. Data on patient demographics, comorbidities, tumour characteristics, surgical details, flap characteristics, complications, and long-term oncological outcomes were collected and analysed.

Results: The study included 30 patients with a mean age of 75.4 years, most of whom had significant comorbidities. The flap success rate was 93.3%, with minimal donor site morbidity. The aesthetic outcomes were favourable, with the flap providing a good match of colour and texture. Oncological safety was affirmed, with no nodal transfers observed.

Conclusions: The SIF is a reliable and aesthetically favourable option for parotid region reconstruction, particularly in elderly patients with multiple comorbidities. Its use minimises donor site morbidity and does not require microsurgical expertise. Careful patient selection is critical to avoid complications, particularly in those with a history of submental trauma, and to not risk metastatic lymph node transfer in advanced nodal disease. The SIF allows for effective reconstruction without compromising oncological outcomes, supporting its use as a standard approach in appropriate cases.